Acta Scientific Clinical Case Reports

Case Report Volume 2 Issue 7

A Case of Late Bronchopleural Fistula in a Patient of Liver Transplant and Interstitial Lung Disease

Ajoy Krishna Sarkar1, Arindam Mukherjee2, Sayan Das3, Bhaswati Dasgupta Nath4, Raja Basu5, Avijit Das6 and Abhraneel Guha7*

1Clinical Director of Critical Care and Head of the Unit Pulmonary Medicine, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India
2Consultant Respiratory Medicine, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India
3Consultant Interventional Radiologist, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India
4Consultant Internal Medicine, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India
5Consultant Internal Medicine and Intensivist, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India
6Consultant Tropical Medicine, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India
7Senior Registrar, Internal Medicine, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India

*Corresponding Author: Abhraneel Guha, Senior Registrar, Internal Medicine, Peerless Hospital and B.K. Roy Research Centre, Kolkata, West Bengal, India.

Received: May 17, 2021; Published: June 05, 2021

Abstract

60-year-old male patient with a background of post liver transplant from living donor 10 years back and also diagnosed interstitial lung disease (ILD) 2 years back presented with a left sided pneumothorax with bronchopleural fistula (BPF) in February this year. He was managed initially in a local hospital with intercostal chest drain. Because of persistent bronchopleural fistula, his left lung remained in a state of partial collapse. He was admitted in our hospital with respiratory distress due to surgical emphysema in addition to pneumothorax. After changing the intercostal drain, surgical emphysema got better but there was no sign of improvement of his bronchopleural fistula. A CT scan of the chest revealed moderate amounts of pneumothorax on left pleural space with ICD seen in situ. Three dimensional reconstruction of CT thorax suggested a possible fistula in the left anterior upper segmental bronchus. Localization of BPF was confirmed by inflating a 4F fagoti balloon followed by injecting Iohexol dye in the above subsagement through fibre optic bronchoscopy. Subsequently bronchoscopy guided endobronchial glueing and closure of the BPF was done. Repeat CT scan confirmed closure of the BPF and resolution of the pneumothorax was noted. Patient was discharged in a stable condition.

Keywords: Bronchopleural Fistula; Liver Transplant; Endobronchial Glueing; Fiberoptic Bronchoscopy; Interstitial Lung Disease

References

  1. Dunn DL. “Hazardous crossing: immunosuppression and nosocomial infections in solid organ transplant recipients”. Surgical Infections2 (2001): 103-112.
  2. Lois M and Noppen M. “Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management”. Chest6 (2005): 3955-3965.
  3. Judson MA and Sahn SA. “The pleural space and organ transplantation”. American Journal of Respiratory and Critical Care Medicine3 (1996): 1153-1165.
  4. Jichen QV., et al. “Risk factor comparison and clinical analysis of early and late bronchopleural fistula after non-small cell lung cancer surgery”. The Annals of Thoracic Surgery5 (2009): 1589-1593.
  5. Kupeli E., et al. “Diagnostic utility of flexible bronchoscopy in recipients of solid organ transplants”. In Transp Lantation Proceedings 2011 43.2 (2011): 543-546.
  6. Sherman M., et al. “Pneumocystis carinii pneumonia with spontaneous pneumothorax: a report of three cases”. Chest 4 (1986): 609-610.
  7. Stern EJ., et al. “Peripheral bronchopleural fistulas: CT imaging features”. American Journal of Roentgenology 167.1 (1996): 117-120.
  8. Aihara K., et al. “Efficacy of blood-patch pleurodesis for secondary spontaneous pneumothorax in interstitial lung disease”. Internal Medicine 11 (2011): 1157-1162.
  9. Chen CH., et al. “Secondary spontaneous pneumothorax: which associated conditions benefit from pigtail catheter treatment?” The American Journal of Emergency Medicine 1 (2012): 45-50.
  10. Ricci ZJ., et al. “Role of computed tomography in guiding the management of peripheral bronchopleural fistula”. Journal of Thoracic Imaging 3 (2002): 214-218.
  11. Gaur P., et al. “Bronchopleural fistula and the role of contemporary imaging”. The Journal of Thoracic and Cardiovascular Surgery1 (2014): 341-347.
  12. Matsuoka K., et al. “Preoperative hypoalbuminemia is a risk factor for late bronchopleural fistula after pneumonectomy”. Annals of Thoracic and Cardiovascular Surgery: Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia6 (2010): 401-405.
  13. Fiorelli A., et al. “Bronchopleural fistula closed with cellulose patch and fibrin glue”. Asian Cardiovascular and Thoracic Annals7 (2015): 880-883.
  14. Klotz LV., et al. “Endobronchial closure of bronchopleural fistula using Amplatzer device”. Journal of Thoracic Disease8 (2015): 1478.

Citation

Citation: Abhraneel Guha., et al. “A Case of Late Bronchopleural Fistula in a Patient of Liver Transplant and Interstitial Lung Disease". Acta Scientific Clinical Case Reports 2.7 (2021): 38-42.

Copyright

Copyright: © 2021 Abhraneel Guha., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 30, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US